Please fill out this form to report any concerns, incidents in class, impropriety, or instances of racism. We will follow up with next steps as soon as possible. Class Incident Report Please use this form to report an incident of misconduct you received or witnessed. Incident Date* Date Format: MM slash DD slash YYYY Class Name*Instructor Name*Your Name*During today's class, I was a...*Teaching ArtistStudentModeratorYour Email AddressPlease provide a contact email address if you would like to receive a follow-up email regarding the recourse of this incident. Date of Incident* Date Format: MM slash DD slash YYYY Location of Incident*Name of person grievance is being filed against:*Person's contact email, if availablePlease describe the event in as much detail as possible:*Please cite any policies, procedures, or guidelines you feel have been violated:Were there any witnesses?*YesNoI'm not sureIf yes, please provide names and contact information for the witnesses:Is this the first time you've raised this concern about this person?*YesNoSpecifically referencing this concern. Proposed solution of grievance:*Please upload any files affiliated with this incident, if any. Drop files here or Consent* I understand and agreeI understand by checking this box that my incident report will be sent to Joy of Motion's Executive Leadership & the Joy of Motion's Faculty Committee who will then create a recourse plan for this incident. Depending on the severity of the incident, this information may also be shared with Joy of Motion's Board of Directors.